31 Aug 2022


Prenatal Breastfeeding Education Quality Improvement Research

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Academic level: Ph.D.

Paper type: Research Paper

Words: 1306

Pages: 4

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Breastfeeding infants makes them to develop into healthy growing children. Breast milk forms the first food for every new life necessary for a vast of critical reasons including availing to them the correct amount of fat, sugar, water, minerals, and proteins; it is easily digested, and lowers the risk of sudden infant death syndrome (SIDS) (The American College of Obstetricians and Gynecologists, 2016). Notably, cognitive, physiological, and emotional perspectives are built by the primary breastfeeding program that the mother offers their child. Therefore, providing breastfeeding education is responsible for several positive reasons, which gainfully aid a child regarding immunity and typical wellbeing. More specifically, knowledge for improving the lactation of an infant given to pregnant mothers boosts the aspect of quality delivery to a child’s feeding (The American College of Obstetricians and Gynecologists, 2016). Usually, when a mother gets breastfeeding education following their first pregnancy, there are high chances of successful breastfeeding for subsequent pregnancies. Furthermore, based on the importance that breast milk bestows, there is an immeasurable need to increase the number of lactating mothers as well as improving the standards through the infant feeding plans. Therefore, it is essential to discuss the importance of prenatal breastfeeding education, data to support that prenatal breastfeeding education is low, the roles of nurses, certified nursing assistants, and physicians in improving prenatal breastfeeding, the use of the Ready, Set, BABY (RSB) curriculum as an evidence-based practice (EBP) at North Carolina Women’s Hospital. 

Importance of Prenatal Breastfeeding Education 

Even though breastfeeding instigation rates have improved significantly in various developed nations over the past several decades, breastfeeding period and exclusivity remains suboptimal (Wong, Tarrant & Lok, 2015). Availing infant feeding education and counseling to pregnant females is Step Three of the Ten Steps to Successful Breastfeeding, whose implementation leads to a positive, dose ‐ response correlation with breastfeeding initiation, exceptionality, and duration (Parry, Tully, Hopper, Schildkamp & Labbok, 2018). Many new mothers report that they are mainly unprepared for their early breastfeeding encounters. Therefore, inclusive prenatal education on ideal infant feeding with continuousness of holistic support postpartum is commended due to the need to make the most of maternal readiness for handling lactation physiology. Through prenatal education, mothers anticipating to entirely breastfeed end up doing so because they rarely have their newborns complemented with infant formula together with supplements, which have a significant negative consequence on breastfeeding duration. Moreover, prenatal education avails knowledge concerning Baby ‐ Friendly maternity care conducts including the significance of skin ‐ to ‐ skin contact, standard care twenty-four ‐ hour rooming ‐ in, together with the risks of supplementation. 

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Data to Support that Prenatal Breastfeeding Education is Low and Needs to be Improved to Increase Exclusive Breastfeeding Rates and Infants' and Mothers' Health 

Compared to reviews concentrating on postnatal breastfeeding intrusions, there are lesser reviews on prenatal breastfeeding interventions. Only one lately published Cochrane review encompassed all procedures of antenatal interventions meant to enhance breastfeeding duration. On the other hand, only one review published in 2001 recommended that group education is the single strategy during pregnancy shown to lengthen breastfeeding duration (Wong, Tarrant & Lok, 2015). However, the review comprised only one study reporting on the efficiency of one-to-one individual education since the existing evidence was limited. Similarly, two additional reviews compared the efficacy of group versus individual antenatal education on various pregnancy outcomes. 

One of the reviews excluded studies centered only on enhancing breastfeeding results, and no breastfeeding data were conveyed. Regarding the second review, it inspected the influence of group versus individual antenatal education on degrees of preterm birth and low birth weight; while breastfeeding beginning and duration were only subordinate outcomes (Wong, Tarrant & Lok, 2015). Based on this review, one randomized study preferred group education while one cohort study exhibited no substantial variance in prolonging the mean breastfeeding duration. As such, the current evidence level is inadequate to commend inclusive individual or group antenatal breastfeeding education for all pregnant women as an approach to increase breastfeeding outcomes. 

The Roles of Team Members to Accomplish the Goals of Improving Prenatal Breastfeeding 

Nurses are charged with ensuring prenatal education by holding brief breastfeeding discussions and offering written educational resources to expectant mothers during their routine clinic appointments (Wouk, Tully & Labbok, 2016). This is mainly done by registered nurses who accomplished WHO/UNICEF’s breastfeeding course, and have substantial breastfeeding research experience. On the other hand, certified nursing assistants (CNA's) do visit prenatal education participants two times during pregnancy to offer necessary information about breastfeeding and expressing milk; and get women ready to forestall future breastfeeding problems for six months and more. Furthermore, physicians are among the educators who deliver the breastfeeding curriculum to expectant women (Parry, Tully, Hopper, Schildkamp & Labbok, 2018). In this case, Wouk, Tully, and Labbok (2016) hold that low-income pregnant women aged eighteen and above, uncertain about feeding methods or scheduling to bottle feed, get care at a private, urban physician’s office in Houston. 

Solutions to Improve Prenatal Breastfeeding Education and Increasing Breastfeeding Rates at North Carolina Women’s Hospital 

The Ready, Set, BABY (RSB) is a curriculum established to counsel women on the benefits of breastfeeding and management. It was instigated between 2012 and 2015 through a collaborative determination of the International Board Certified Lactation Consultants at the Carolina Global Breastfeeding Institute and North Carolina Women’s Hospital, together with researchers at the University of North Carolina at Chapel Hill (Parry, Tully, Hopper, Schildkamp & Labbok, 2018). RSB has commendations for prenatal education from the Baby-Friendly Hospital Initiative, the Academy of Breastfeeding Medicine, and writings on why the U.S. breastfeeding females give human milk alternatives or rashly wean. As such, patients of at least eighteen years got enlisted in the research sites by the collaborators and filled a questionnaire before and after RSB (Parry, Tully, Hopper, Schildkamp & Labbok, 2018). Subsequently, the pre ‐ and post-intervention association, motherly participation in RSB expressively enhanced Infant Feeding Intentions Scale scores, and acquaintance with Baby ‐ Friendly suggested maternity care conducts, while considerably lowering the luxury of formula feeding. 

Evidence-Based Practice to support Baby-Friendly Hospital Initiative Step 3: Prenatal Breastfeeding Education 

Evidence-based practice (EBP) is vital in the conveyance of the highest quality of healthcare and guaranteeing the best patient outcomes. Results from many studies have shown that an evidence-based methodology to practice as opposed to the implementation of clinical care immersed in tradition or outdated guidelines lead to a host of enhanced health, safety, and cost results, comprising a decline in patient morbidity and mortality (Melnyk & Fineout-Overholt, 2011) . Availing infant breastfeeding education and therapy to women while pregnant is Step Three of the Ten Steps to Successful Breastfeeding (Ten Steps). 

The implementation of the Ten Steps is associated with a constructive, dose ‐ rejoinder relationship with breastfeeding beginning, exclusivity, and duration, and is regarded to be a portion of evidence ‐ based, family ‐ centered care (Parry, Tully, Hopper, Schildkamp & Labbok, 2018) . As such, the RSB is an evidence-based practice to support the Baby-Friendly Hospital Initiative Step 3: Prenatal Breastfeeding Education. The RSB materials entail a twenty-eight ‐ page color patient booklet, an instructor flipchart with recommended text, together with a digital file to display portions of the flipchart on a screen during group settings (Parry, Tully, Hopper, Schildkamp & Labbok, 2018) . RSB is found in English and Spanish, allocated into four sections, and contains a total of fourteen content topics, which are introduced with a question meant to engage the patient in a discussion about what they think of the subject before the instructor offers the information (Parry, Tully, Hopper, Schildkamp & Labbok, 2018)

Lesson learned: What Worked 

RSB partaking led to substantial knowledge enhancement on Baby ‐ Friendly maternity care processes. For example, the proportion of partakers who testified that skin ‐ to ‐ skin contact significantly rose from 89.0% before RSB involvement to 99.1% after partaking RSB (Parry, Tully, Hopper, Schildkamp & Labbok, 2018) . Also, the number of females who projected to remain with their babies all through rose from 296 to 315 after partaking RSB. Likewise, the participants became aware of the risks of supplementation like lowering milk supply, making breastfeeding more problematic, and infants being more likely to get sick (Parry, Tully, Hopper, Schildkamp & Labbok, 2018) . Similarly, the women were able to learn of the early baby feeding signals after RSB like sucking their tongue, opening their mouth while whirling the head to the sides, getting a hand to their mouth, and having fluttering eyes. 


Breastfed infants develop into healthy children. As such, implementing prenatal breastfeeding education leads to a positive, dose ‐ response correlation with breastfeeding initiation, exceptionality, and duration. Also, prenatal education on ideal infant feeding makes the most of maternal readiness for handling lactation physiology. However, compared to reviews concentrating on postnatal breastfeeding intrusions, there are lesser reviews on prenatal breastfeeding interventions. To ensure, the dissemination of prenatal education, nurses, certified nursing assistants, and physicians are involved. The North Carolina Women’s Hospital implemented a solution to improve prenatal breastfeeding education and increasing breastfeeding rates through the Ready, Set, BABY (RSB) curriculum. This is an evidence-based Practice to support the Baby-Friendly Hospital Initiative Step 3: Prenatal Breastfeeding Education. Consequently, RSB led to substantial knowledge enhancement on baby ‐ friendly maternity care processes. 


Melnyk, B., & Fineout-Overholt, E. (2011).  Evidence-based practice in nursing & healthcare . Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. 

Parry, K., Tully, K., Hopper, L., Schildkamp, P., & Labbok, M. (2018). Evaluation of Ready, Set, BABY: A prenatal breastfeeding education and counseling approach.  Birth 46 (1), 113-120. doi: 10.1111/birt.12393 

The American College of Obstetricians and Gynecologists. (2016). Breastfeeding Your Baby. Retrieved from https://www.acog.org/Patients/FAQs/Breastfeeding-Your-Baby?IsMobileSet=false 

Wong, K., Tarrant, M., & Lok, K. (2015). Group versus Individual Professional Antenatal Breastfeeding Education for Extending Breastfeeding Duration and Exclusivity.  Journal Of Human Lactation 31 (3), 354-366. doi: 10.1177/0890334415583294 

Wouk, K., Tully, K., & Labbok, M. (2016). Systematic Review of Evidence for Baby-Friendly Hospital Initiative Step 3.  Journal of Human Lactation 33 (1), 50-82. doi: 10.1177/0890334416679618 

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